OMB control number
Waiver of Supplemental Security Income Payment Continuation
OMB 0960-0783 · SSA.
The NOPA SSA sends to the recipient explains the waiver process, and how respondents can access Form SSA-263 to request a waiver. The SSA-263 collects the following information and acknowledgements from an SSI recipient: • the respondent’s name; • social security number; • acknowledgement that SSA may reduce, suspend, or terminate their SSI payment; • acknowledgement of the right to payment continuation; • acknowledgement of the right to request and receive payment continuation at any time before we make a determination on the appeal; • acknowledgement that we have explained the rights; and, • acknowledgement that the SSI recipient understands the rights concerning the waiver and receipt of payment continuation. SSI recipients may print the form on their own from SSA’s website or contact a field office to request the form. We use the SSA-263 to provide a modality through which an SSI recipient communicates to us that they do not wish to receive payment continuation. Waiver of payment continuation is voluntary. Therefore, SSI recipients complete the SSA-263 at their own discretion if they do not wish to receive payment continuation once they receive a NOPA from SSA to reduce, suspend, or terminate their SSI payment(s). SSI recipients complete the SSA-263 on their own or with the assistance from a field office technician. SSA uses the information we collect on the SSA-263 to process a waiver of payment continuation. The respondents for this collection are SSI recipients who receive a NOPA to reduce, suspend, or terminate their SSI payments.
The latest form for Waiver of Supplemental Security Income Payment Continuation expires 2026-07-31 and can be found here.
Document Name |
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Form and Instruction |
Supporting Statement A |
Supplementary Document |
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Approved with change |
Revision of a currently approved collection | 2022-10-04 | |
|
Approved without change |
Revision of a currently approved collection | 2019-08-07 | |
|
Approved without change |
Revision of a currently approved collection | 2016-07-04 | |
|
Approved without change |
Revision of a currently approved collection | 2013-06-27 | |
|
Approved without change |
Existing collection in use without an OMB Control Number | 2010-04-19 |